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Geographic Inequalities in All-Cause Mortality in Japan: Compositional or Contextual?

Author

Listed:
  • Etsuji Suzuki
  • Saori Kashima
  • Ichiro Kawachi
  • S V Subramanian

Abstract

Background: A recent study from Japan suggested that geographic inequalities in all-cause premature adult mortality have increased since 1995 in both sexes even after adjusting for individual age and occupation in 47 prefectures. Such variations can arise from compositional effects as well as contextual effects. In this study, we sought to further examine the emerging geographic inequalities in all-cause mortality, by exploring the relative contribution of composition and context in each prefecture. Methods: We used the 2005 vital statistics and census data among those aged 25 or older. The total number of decedents was 524,785 men and 455,863 women. We estimated gender-specific two-level logistic regression to model mortality risk as a function of age, occupation, and residence in 47 prefectures. Prefecture-level variance was used as an estimate of geographic inequalities in mortality, and prefectures were ranked by odds ratios (ORs), with the reference being the grand mean of all prefectures (value = 1). Results: Overall, the degree of geographic inequalities was more pronounced when we did not account for the composition (i.e., age and occupation) in each prefecture. Even after adjusting for the composition, however, substantial differences remained in mortality risk across prefectures with ORs ranging from 0.870 (Okinawa) to 1.190 (Aomori) for men and from 0.864 (Shimane) to 1.132 (Aichi) for women. In some prefectures (e.g., Aomori), adjustment for composition showed little change in ORs, while we observed substantial attenuation in ORs in other prefectures (e.g., Akita). We also observed qualitative changes in some prefectures (e.g., Tokyo). No clear associations were observed between prefecture-level socioeconomic status variables and the risk of mortality in either sex. Conclusions: Geographic disparities in mortality across prefectures are quite substantial and cannot be fully explained by differences in population composition. The relative contribution of composition and context to health inequalities considerably vary across prefectures.

Suggested Citation

  • Etsuji Suzuki & Saori Kashima & Ichiro Kawachi & S V Subramanian, 2012. "Geographic Inequalities in All-Cause Mortality in Japan: Compositional or Contextual?," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0039876
    DOI: 10.1371/journal.pone.0039876
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    References listed on IDEAS

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    1. Fukuda, Yoshiharu & Nakamura, Keiko & Takano, Takehito, 2004. "Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973-1998," Social Science & Medicine, Elsevier, vol. 59(12), pages 2435-2445, December.
    2. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    3. Krieger, Nancy, 1994. "Epidemiology and the web of causation: Has anyone seen the spider?," Social Science & Medicine, Elsevier, vol. 39(7), pages 887-903, October.
    4. Diez-Roux, A.V., 1998. "Bringing context back into epidemiology: Variables and fallacies in multilevel analysis," American Journal of Public Health, American Public Health Association, vol. 88(2), pages 216-222.
    5. Suzuki, Etsuji & Takao, Soshi & Subramanian, S.V. & Komatsu, Hirokazu & Doi, Hiroyuki & Kawachi, Ichiro, 2010. "Does low workplace social capital have detrimental effect on workers' health?," Social Science & Medicine, Elsevier, vol. 70(9), pages 1367-1372, May.
    6. repec:dau:papers:123456789/10510 is not listed on IDEAS
    7. Nakaya, Tomoki & Dorling, Danny, 2005. "Geographical inequalities of mortality by income in two developed island countries: a cross-national comparison of Britain and Japan," Social Science & Medicine, Elsevier, vol. 60(12), pages 2865-2875, June.
    8. S V Subramanian & Craig Duncan & Kelvyn Jones, 2001. "Multilevel Perspectives on Modeling Census Data," Environment and Planning A, , vol. 33(3), pages 399-417, March.
    9. Roux, A.V.D., 2011. "Complex systems thinking and current impasses in health disparities research," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 1627-1634.
    10. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    11. Macintyre, Sally & Ellaway, Anne & Cummins, Steven, 2002. "Place effects on health: how can we conceptualise, operationalise and measure them?," Social Science & Medicine, Elsevier, vol. 55(1), pages 125-139, July.
    12. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
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    1. Perseus W.F. Wong & Jimmy S.M. Lai & Jonathan C.H. Chan, 2020. "A Serial Cross-Sectional Analysis of the Prevalence, Risk Factors and Geographic Variations of Reduced Visual Acuity in Primary and Secondary Students from 2000 to 2017 in Hong Kong," IJERPH, MDPI, vol. 17(3), pages 1-22, February.
    2. Emerson Augusto Baptista & Kaoru Kakinuma & Bernardo Lanza Queiroz, 2020. "Association between Cardiovascular Mortality and Economic Development: A Spatio-Temporal Study for Prefectures in Japan," IJERPH, MDPI, vol. 17(4), pages 1-16, February.

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